Sexual dysfunction occurs in men and women and the prevalence increases with age. Dysfunction can occur in one or more areas of the normal sexual response cycle: desire, arousal, or orgasm. It can also be due to pain. Family physicians should routinely screen all men and women for sexual dysfunction, given its high prevalence and high correlation with other conditions. Risk factors include use of prescription drugs (eg, selective serotonin reuptake inhibitors, diuretics, antihormonals), recreational drugs, alcohol, and/or nicotine; certain health and lifestyle issues; and many chronic medical conditions, such as heart disease and diabetes. Diagnosis is based on clinical features; therefore, a detailed sexual history and focused physical examination are critical. Laboratory testing, imaging, and management are tailored to the suspected condition. Although some therapies require referral, education of patients about the normal sexual response cycle, discontinuation or changing of drugs, screening for and management of comorbid conditions, and counseling and guidance about lifestyle changes or use of devices all can be addressed in the family medicine setting.
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